A multicenter trial of an intrabronchial valve for treatment of severe emphysema.

Objectives: Minimally invasive endoscopic treatment of emphysema could provide palliation with less risk than lung volume reduction surgery and offer therapy to patients currently not considered for lung volume reduction surgery. The Intrabronchial Valve is used to block bronchial airflow in the most emphysematous areas of lung.

Methods: Patients with severe chronic obstructive pulmonary disease and heterogeneous upper lobe-predominant emphysema were eligible.

Promoting HIV Vaccine Research in African American Communities: Does the Theory of Reasoned Action Explain Potential Outcomes of Involvement?

The HIV/AIDS pandemic continues to challenge the African American community with disproportionate rates of infection, particularly among young women ages 25 to 34 years. Development of a preventive HIV vaccine may bring a substantial turning point in this health crisis. Engagement of the African American community is necessary to improve awareness of the effort and favorably influence attitudes and referent norms.

The response of prototype plane-parallel ionization chambers in small megavoltage x-ray fields.

Accurate small-field dosimetry has become important with the use of multiple small fields in modern radiotherapy treatments such as IMRT and stereotactic radiosurgery. In this study, we investigate the response of a set of prototype plane-parallel ionization chambers, based upon the Exradin T11 chamber, with active volume diameters of 2, 4, 10, and 20 mm, exposed to 6 MV stereotactic radiotherapy x-ray fields. Our goal was to assess their usefulness for accurate small x-ray field dose measurements.

Phase 2 study of an HIV-1 canarypox vaccine (vCP1452) alone and in combination with rgp120: negative results fail to trigger a phase 3 correlates trial.

Background: A goal of T-cell HIV vaccines is to define the correlation between a vaccine-induced immune response and protection from HIV infection. We conducted a phase 2 trial to determine if a canarypox vaccine candidate (vCP1452) administered with rgp120 subunit protein would "qualify" for a trial to define a correlate of efficacy.

Methods: A total of 330 healthy volunteers were enrolled into 4 groups: 120 received vCP1452 alone (0, 1, 3, and 6 months), 120 received vCP1452 with 2 different regimens of rgp120 coadministration, and 90 received placebo.

Initial experience with Lodox Statscan imaging system for detecting injuries of the pelvis and appendicular skeleton.

The purpose of this study is to assess detection of pelvic and extremity injuries employing a rapid whole-body imaging system (Lodox Statscan). We retrospectively reviewed 37 consecutive cases. The study was approved by our hospital review board and carried out with Health Insurance Portability and Accountability Act (HIPAA) compliance.

PET/CT and MR imaging in myeloma.

Myeloma is the most common primary bone malignancy. It accounts for 10% of all hematological malignancies and 1% of all cancers. In the United States, there are an estimated 16,000 new cases and over 11,000 deaths yearly due to myeloma.

Interleukin-6 regulation of direct lung ischemia reperfusion injury.

Background: Lung ischemia reperfusion injury continues to adversely affect patient and graft survival after transplantation. While the role of interleukin-6 has been studied in ischemia-reperfusion models of intestine, liver, and heart, its participation in lung reperfusion injury has not been characterized.

Methods: We administered recombinant interleukin-6 to rat lungs through the intratracheal route before inducing left lung ischemia and reperfusion.

Excellent safety and tolerability of the human immunodeficiency virus type 1 pGA2/JS2 plasmid DNA priming vector vaccine in HIV type 1 uninfected adults.

A vaccine consisting of DNA priming followed by recombinant modified vaccinia Ankara (rMVA) boosting has achieved long-term control of a pathogenic challenge with a chimera of simian and human immunodeficiency viruses (SHIV-89.6P) in rhesus macaques. Based on these results, clade B HIV-1 DNA and rMVA immunogens have been developed for trials in humans.

Optimizing a canine survival model of orthotopic lung transplantation.

Introduction: While acute models of orthotopic lung transplantation have been described in dogs, the technical considerations of developing a survival model in this species have not been elaborated. Herein, we describe optimization of a canine survival model of orthotopic lung transplantation.

Methods: Protocols of orthotopic left lung transplantation and single lung ventilation were established in acute experiments (n=9).

Comparison of imaging with FDG PET/CT with other imaging modalities in myeloma.

Objective: To determine the usefulness of FDG PET/CT scanning in the management and staging of myeloma and to assess its strengths and limitations.

Design: FDG PET/CT scans and all other available imaging studies were reviewed retrospectively from 16 consecutive patients by two experienced musculoskeletal radiologists and two nuclear medicine physicians working in consensus.

Patients: The 16 patients had undergone a total of 19 FDG PET/CT scans.

Toward understanding the genetics of alcohol drinking through transcriptome meta-analysis.

Much evidence from studies in humans and animals supports the hypothesis that alcohol addiction is a complex disease with both hereditary and environmental influences. Molecular determinants of excessive alcohol consumption are difficult to study in humans. However, several rodent models show a high or low degree of alcohol preference, which provides a unique opportunity to approach the molecular complexities underlying the genetic predisposition to drink alcohol.

Nocturic frequency is related to severity of obstructive sleep apnea, improves with continuous positive airways treatment.

Objective: The purpose of this study was to determine the relationship between nocturia and obstructive sleep apnea (OSA), and the effect of continuous positive airways pressure (CPAP) therapy on nocturic frequency.

Study Design: This was a retrospective review of sleep studies including patients with and without evidence of OSA, before and during CPAP treatment (where relevant). Chi-squared tests compared nocturia prevalence according to sleep diagnosis, logistic regression determined predictors of nocturia, and regression analyses determined predictors of nocturic frequency.

Long-term outcome of esophagectomy for high-grade dysplasia or cancer found during surveillance for Barrett's esophagus.

Endoscopic surveillance is recommended for patients with Barrett's esophagus to detect high-grade dysplasia (HGD) or cancer. We studied the outcome of esophagectomy in a cohort of patients who developed HGD or cancer between 1995 and 2003 while under surveillance for Barrett's. Outcomes were measured by analysis of clinical records, symptom questionnaire, and SF-36 (version 2).

Crosstalk between thrombosis and inflammation in lung reperfusion injury.

Background: Activation of extravascular coagulation has been reported in acute lung injury models of sepsis and acute respiratory distress syndrome. Thrombin, the main effector protease of extravascular coagulation, activates proinflammatory cell types, including macrophages, endothelial cells, and neutrophils, each of which participates in lung ischemia-reperfusion injury. We used hirudin, a potent, specific direct thrombin inhibitor, to define the role of thrombin in lung ischemia-reperfusion injury.

Tunnel convergence in combined anterior cruciate ligament and posterolateral corner reconstruction.

Purpose: To examine the geometric relationship between tunnels created in the lateral femoral condyle in reconstruction of the anterior cruciate ligament (ACL) and the posterolateral structures.

Methods: The geometric relationship between a standard ACL tunnel and 11 lateral femoral tunnel variations in synthetic femur specimens was examined. Tunnel collision frequency and tunnel separation were measured radiographically.

The Art and Science of Immunosuppression: the Fifth Annual American Society of Transplant Surgeon's State-of-the-Art Winter Symposium.

The 2005 American Society of Transplant Surgeons (ASTS) Winter Symposium entitled 'The Art and Science of Immunosuppression' explored ways to maximize existing immunosuppressive protocols and to develop new strategies incorporating novel agents and emerging diagnostic technologies to customize immunosuppression and reduce side effects. Several presentations evaluated steroid withdrawal or avoidance protocols reflecting the significant difficulties of bone loss, glucose control and growth retardation in children associated with long-term steroid use. Calcineurin-inhibitor related renal dysfunction of both native and transplanted kidneys was identified as significant, but no consensus was reached concerning effective prevention.

Tissue inhibitor of metalloproteinase-1 deficiency abrogates obliterative airway disease after heterotopic tracheal transplantation.

Obliterative bronchiolitis (OB) is a major cause of allograft dysfunction after lung transplantation and is thought to result from immunologically mediated airway epithelial destruction and luminal fibrosis. Matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) have been implicated in the regulation of lung inflammation, airway epithelial repair, and extracellular matrix remodeling and therefore may participate in the pathogenesis of OB. The goals of this study were to determine the expression profiles of MMPs and TIMPs and the role of TIMP-1 in the development of airway obliteration using the murine heterotopic tracheal transplant model of OB.

Imaging techniques used in the diagnosis, staging, and follow-up of patients with myeloma.

Radiologists play a central role in the diagnosis, initial staging, follow-up, and restaging of patients with myeloma. This review article attempts to familiarize the reader with all the various types of myeloma, their imaging appearances and useful imaging strategies. The staging system for myeloma patients has been updated and now includes findings from advanced imaging modalities.

The effect of anti-inflammatory properties of mycophenolate mofetil on the development of lung reperfusion injury.

Background: Lung ischemia-reperfusion injury (LIRI) is associated with an increased incidence of both primary graft failure and obliterative bronchiolitis. The immunosuppressant mycophenolate mofetil (MMF) has recently been shown to attenuate inflammatory injury in acute ischemia-reperfusion models via a mechanism that is presently unclear. These experiments studied the effects of MMF in a warm, in situ LIRI model, focusing on transcriptional regulation of pro-inflammatory mediators.

Posterior-inferior glenoid rim shapes by MR imaging.

Our purpose was to try to apply a CT classification of glenoid rim shapes to MR images and to determine the reliability of the subsequent MR classification by testing observer variability. Shoulder MR imaging exams of 54 consecutive patients were reviewed retrospectively by two musculoskeletal radiologists independently. Posterior-inferior glenoid rim shape was categorized, based on reported CT criteria, as triangle, "lazy-J" or "delta" using the most caudal MR section that unequivocally showed articular cartilage.

Intramedullary nailing in a tibial shaft fracture with distal articular extension.

Newer-generation intramedullary nails that allow placement of distal locking screws near the end of the nail have helped extend the indications for nailing in different types of tibial fractures.